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01-12-2024 | Urolithiasis | Invited Review

Ureteral stricture rate after endoscopic treatments for urolithiasis and related risk factors: systematic review and meta-analysis

Authors: S. Moretto, A. Saita, C. M. Scoffone, M. Talso, B. K. Somani, O. Traxer, O. Angerri, T. Knoll, E. Liatsikos, T. R. W. Herrmann, Ø. Ulvik, A. Skolarikos, C. M. Cracco, E. X. Keller, M. Paciotti, A. Piccolini, A. Uleri, T. Tailly, L. Carmignani, A. Pietropaolo, M. Corrales, G. Lughezzani, M. Lazzeri, V. Fasulo, V. De Coninck, P. Arena, U. Nagele, S. Ferretti, P. Kronenberg, D. Perez-Fentes, P. J. Osther, I. K. Goumas, P. Acquati, L. Ajayi, P. Diana, P. Casale, N. M. Buffi

Published in: World Journal of Urology | Issue 1/2024

Abstract

Purpose

We aimed to accurately determine ureteral stricture (US) rates following urolithiasis treatments and their related risk factors.

Methods

We conducted a systematic review and meta-analysis following the PRISMA guidelines using databases from inception to November 2023. Studies were deemed eligible for analysis if they included ≥ 18 years old patients with urinary lithiasis (Patients) who were subjected to endoscopic treatment (Intervention) with ureteroscopy (URS), percutaneous nephrolithotomy (PCNL), or shock wave lithotripsy (SWL) (Comparator) to assess the incidence of US (Outcome) in prospective and retrospective studies (Study design).

Results

A total of 43 studies were included. The pooled US rate was 1.3% post-SWL and 2.1% post-PCNL. The pooled rate of US post-URS was 1.9% but raised to 2.7% considering the last five years’ studies and 4.9% if the stone was impacted. Moreover, the pooled US rate differed if follow-ups were under or over six months. Patients with proximal ureteral stone, preoperative hydronephrosis, intraoperative ureteral perforation, and impacted stones showed higher US risk post-endoscopic intervention with odds ratio of 1.6 (P = 0.05), 2.6 (P = 0.009), 7.1 (P < 0.001), and 7.47 (P = 0.003), respectively.

Conclusions

The overall US rate ranges from 0.3 to 4.9%, with an increasing trend in the last few years. It is influenced by type of treatment, stone location and impaction, preoperative hydronephrosis and intraoperative perforation. Future standardized reporting and prospective and more extended follow-up studies might contribute to a better understanding of US risks related to calculi treatment.

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Title: Ureteral stricture rate after endoscopic treatments for urolithiasis and related risk factors: systematic review and meta-analysis
Authors: S. Moretto
A. Saita
C. M. Scoffone
M. Talso
B. K. Somani
O. Traxer
O. Angerri
T. Knoll
E. Liatsikos
T. R. W. Herrmann
Ø. Ulvik
A. Skolarikos
C. M. Cracco
E. X. Keller
M. Paciotti
A. Piccolini
A. Uleri
T. Tailly
L. Carmignani
A. Pietropaolo
M. Corrales
G. Lughezzani
M. Lazzeri
V. Fasulo
V. De Coninck
P. Arena
U. Nagele
S. Ferretti
P. Kronenberg
D. Perez-Fentes
P. J. Osther
I. K. Goumas
P. Acquati
L. Ajayi
P. Diana
P. Casale
N. M. Buffi
Publication date: 01-12-2024
Publisher: Springer Berlin Heidelberg
Keywords: Urolithiasis
Ureteral Injury
Published in: World Journal of Urology / Issue 1/2024
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-024-04933-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Ureteral stricture rate after endoscopic treatments for urolithiasis and related risk factors: systematic review and meta-analysis

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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